Add the olive oil to a large skillet and heat over medium-low. When the oil is hot, add the shallot, garlic and oregano. Cook until the shallots are soft and translucent, about 5 minutes.
Reduce heat to low, add the tomato paste and red pepper flakes. Cook until thickened, 4-5 minutes.
Stir in the vodka and cook for another 2 minutes.
Stir in the pesto and cream, then season with salt and pepper. Keep warm over low heat.
Meanwhile, bring a large pot of salted water to a boil. When boiling, add the pasta and cook until al dente. Drain.
To the vodka sauce, add the pasta and butter. Stir until the butter is melted, then add the Parmesan and basil.
Serve topped with additional basil and Parmesan as desired.